Title

Association between periodontal inflammation and cognitive impairment among older adults: A clinical and biomarker-based study

Authors

Ramanarayana Boyapati¹,*, Krishna Rao Kilaru², Sai Archita Tummala³, Bhavyasri Gaddam⁴, Lalitha Chintala⁵ & Ravindranath Dhulipalla⁶

Affiliation

¹Department of Periodontology, Sibar Institute of Dental Sciences, Takkellapadu, Guntur, Andhra Pradesh, India; ²Department of Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America; ³Department of Dentistry, EHR and Claims Analytics, Flair Dental, McKinney, Texas 75070, United States of America; ⁴Department of Oral Diagnostic Sciences & Research, School of Dentistry, Meharry Medical College, Nashville, Tennessee 37208, United States of America; ⁵Department of Oral Medicine and Radiology, Malla Reddy Institute of Dental Sciences, Malla Reddy Vishwavidyapeet (Deemed tobe University), Suraram, Hyderabad, Telangana, India; ⁶Department of Periodontology, Sibar Institute of Dental Sciences, Takkellapadu, Guntur andhra Pradesh, India; *Corresponding author

Email

Ramanarayana Boyapati - E-mail: dr.ramanarayana@gmail.com
Krishna Rao Kilaru - E-mail: kkr167@pitt.edu
Sai Archita Tummala - E-mail: drarchitatummala3@gmail.com
Bhavyasri Gaddam - E-mail: Bgadd335@mmc.edu
Lalitha Chintala - E-mail: lalitha.chintala@mrvv.edu.in
Ravindranath Dhulipalla - E-mail: ravident69@gmail.com

Article Type

Research Article

Date

Received August 1, 2026; Revised August 31, 2026; Accepted August 31, 2026, Published August 31, 2026

Abstract

Cognitive impairment in older adults is influenced by chronic inflammatory exposures and periodontal inflammation may represent a modifiable contributor to systemic inflammatory burden. This clinical and biomarker-based cross-sectional study evaluated 180 adults aged 60 years and older using periodontal examination, periodontal inflamed surface area, Mini-Mental State Examination, Montreal Cognitive Assessment and serum inflammatory markers. Mild cognitive impairment was identified in 68 participants (37.8%) and these participants had significantly higher periodontal inflamed surface area (864 ± 318 mm2) than cognitively normal participants (523 ± 246 mm2; p<0.001). Periodontal inflamed surface area correlated inversely with MoCA score (r=-0.43, p<0.001) and remained independently associated with mild cognitive impairment after adjustment for age, education, diabetes, hypertension and serum C-reactive protein (adjusted OR=1.82 per 250 mm2, p=0.006). Thus, periodontal inflammatory burden was associated with poor cognitive performance and high systemic inflammation, supporting integrated oral and geriatric health assessment.

Keywords

Periodontitis, cognitive impairment, older adults, MoCA, MMSE, PISA, inflammatory biomarkers

Citation

Boyapati et al. Bioinformation 22(8): 5497-5501 (2026)

Edited by

Hiroj Bagde

ISSN

0973-2063

Publisher

Biomedical Informatics

License

This is an Open Access article which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. This is distributed under the terms of the Creative Commons Attribution License.